Oral Pathological Lesions in the Aegean Region: A 30-Year Retrospective Study

Objective: Oral pathological lesions in the mouth vary greatly. However, few studies have evaluated these lesions with long-term data. This study aimed to analyze the demographic parameters (i.e., age, gender, anatomical location, and incidence) of oral pathologies in the Aegean Region. Materials and Methods: In this retrospective study, histopathological reports of 30 years in the Department of Oral Pathology, Faculty of Dentistry, Ege University, were analyzed. Data on sex, age, lesion location, and histopathologic diagnosis were analyzed. Results: The histopathological data of 6,330 patients were evaluated. Most of the pathological oral lesions were osseous lesions (n=3,858), and 2,472 soft tissue pathologies were identified. The posterior mandible was the most common location of these lesions (n=2,011). Conclusion: Determining the variety and frequency of oral pathological lesions at a societal level is important for the management of these lesions

Application of C-Shaped Osteotomy and Distraction Osteogenesis for Correction of Radial Angulation Deformities of the Hand in Children With Apert Syndrome Review of 10 Years of Experience

WOS: 000363321600007PubMed: 25275478Apert syndrome is characterized by short, radially deviated thumbs, leading to difficulties in daily life such as holding a fork or a spoon and buttoning up. The main goal of surgery is to achieve thumb to index finger pinch to overcome these difficulties. Seven patients (14 extremities) followed up with Apert syndrome underwent distraction after a C-shaped osteotomy to simultaneously correct the brachydactyly and the angulation deformity of the bilateral thumbs. The patients ranged in age from 4 to 7 years at the distraction operation, with a mean (SD) of 4.7 (1.7) years, and the mean (SD) length of follow-up was 100.6 (14.95) months. The mean (SD) length of the phalanges at the beginning of distraction was 19.1 (3.26) mm, and the mean (SD) length of the distracted phalanx at long-term follow-up visit was 26.2 (5.63) mm. The mean (SD) correction of radial angulation was calculated as 42.6 (9.95) degrees, and the difference was considered as being statistically significant (P < 0.001). Minor complications such as pin loosening were observed in 6 extremities of 4 patients, and 2 patients were treated for pin tract infection. Index-to-thumb pinching was acquired by all the patients after distraction and correction of angulation. The hand features of Apert syndrome are as noteworthy as the craniofacial features and thus may lead to functional impairment and limitations in daily life. Distraction with a C-shaped osteotomy seems to be a promising method to correct both the shortness and the radial angulation of the thumb to achieve functional results

Unexpected synchronous diagnosis of papillary thyroid carcinoma in a patient with lower lip squamous cell carcinoma

The presentation of differentiated thyroid carcinoma occurring as a second primary associated with head and neck squamous cell carcinoma is quite unusual. Here, we present an unexpected synchronous diagnosis of two independent head and neck malignancies. A 78-year-old male with a rapidly growing, firm, and ulcerated lesion on the lower lip was referred to our clinic. Positron emission tomography-computed tomography scan performed for systemic screening demonstrated a dense hypermetabolic activity located in the right thyroid lobe, suggesting a second malignancy. Fine-needle aspiration cytology of the right thyroid gland performed to differentiate the presence of a metastatic lesion, or primary thyroid cancer was compatible with malign cytology related to papillary thyroid carcinoma. Multiple malignancies may be diagnosed synchronously in the head and neck region and these patients with multiple malignant lesions should be evaluated carefully before being accepted as metastatic

GENERAL APPROACH TO THE TREATMENT OF ODONTOGENIC ABSCESSES AND COST ANALYSIS

WOS: 000409813000003PubMed ID: 28955531Purpose: The purpose of this study was to evaluate the relationships between age, gender, symptoms, treatment, length of hospital stay and hospital cost in a group of patients with severe odontogenic infection who has been admitted within the last 6 years. Subjects and Methods: This study was carried out on 30 patients who had been treated in Ege University, Faculty of Medicine, Otolaryngology Department with the diagnosis of odontogenic abscess. Variables such as age, gender, symptoms, systemic disease, imaging techniques, treatment modalities, hospital length of stay and hospital cost were analyzed statistically. Results: There were 12 female and 18 male patients and their mean age was 39 +/- 19.78 years. Antibiotics were used in all subjects and their abscesses were mostly drained surgically. The mean hospital length of stay was 8.1 days. There was a statistically significant relationship with the presence of systemic disease and hospital length of stay variables (p = 0.017). Conclusion: The cost for treatment of severe odontogenic infections in inpatient units is high in hospitals. Therefore, preventive and routine dental care should be given importance

Submucous Cleft Palate: From Diagnosis to Management

Background/aim: The aim of this study was to investigate submucous cleft palate (SMCP) patients in order to document the age of diagnosis, cause of referral, symptoms and palate findings, objective evaluation of nasalance and velopharyngeal dysfunction (VPD), and intervention type. Material and methods: The archive of Hacettepe University Cleft Lip and Palate, Craniomaxillofacial Anomalies Research, Treatment, and Application Center was reviewed retrospectively, and 166 patients diagnosed with SMCP were documented. Results: The mean age of the patients at the time of initial referral was 10 years and 3 months +/- 8 years and 5 months with the youngest being 1 month and the oldest 44 years old. The primary complaint of 127 (76.5%) patients was speech disorder. Seventy-nine patients underwent surgery, and the mean age was determined as 10 years +/- 6 years and 8 months. Conclusion: The diagnosis of SMCP continues to be rather late, being delayed until a prominent speech disorder is present. Studies for the awareness of health professionals are of great importance for the early diagnosis and intervention of SMCP in order to prevent adverse effects.WoSScopu

Functional Outcomes Of Mandibular Distraction For The Relief Of Severe Airway Obstruction And Feeding Difficulties In Neonates With Pierre Robin Sequence

The purpose of this study was to review the application of mandibular distraction to relieve severe airway obstruction or feeding problems of neonates. Thirteen neonates with Pierre Robin sequence who underwent bilateral mandibular distraction between 2010 and 2013 for relief of their severe airway obstruction or feeding problems were retrospectively reviewed. The mean preoperative and postoperative airway diameters were 3.89 +/- 1.64 and 9.03 +/- 1.98 mm. respectively and significant difference was observed with distraction (p< 0.001). The rate of severe airway infection also significantly decreased from 69.2% to 23.1% (p= 0.016). 84.6% of the patients were able to be fed orally at discharge whereas 6 patients (46.2%) required support via orogastric tube before distraction (p= 0.125). No growth disturbance, dental complications or malocclusion was observed in the long-term follow up. Mandibular distraction appears to be a promising and effective surgical option for relieving airway obstruction and feeding problems in severe Pierre Robin Sequence patients.WoSScopu

Estrogen as a Novel Agent for Induction of Adipose-Derived Mesenchymal Stem Cells for Osteogenic Differentiation: In Vivo Bone Tissue-Engineering Study

WOS: 000335988600007PubMed ID: 24675202Background: This study investigated whether the in vivo osteogenic differentiation potential of adipose-derived mesenchymal stem cells is enhanced by 17-estradiol. Methods: Thirty Sprague-Dawley rats were randomized and divided into five experimental groups. For the surgical procedure, biparietal full-thickness bone defects (7 mm in diameter) were created. A chitosan-hydroxyapatite scaffold was used as the vehicle system for 17-estradiol-loaded nanoparticles and adipose-derived mesenchymal stem cells. The first group, the blank defect group, was the control group. The defects were filled with either scaffold, estradiol, and scaffold; scaffold and adipose-derived mesenchymal stem cells; or estradiol, scaffold, and adipose-derived mesenchymal stem cells as experimental groups. The rats were killed at the end of weeks 4 and 12, and their calvariae were harvested for histologic and microtomographic evaluation. Results: Micro-computed tomographic evaluation of estradiol, scaffold, and adipose-derived mesenchymal stem cells revealed the highest median value (82.59 17.17), and the difference was significant compared with the blank defect group (p = 0.004). Histologic samples demonstrated a significant difference between experimental groups for bone defect repair at the end of weeks 4 and 12 (p = 0.003 and p < 0.001). The estradiol, scaffold, and adipose-derived mesenchymal stem cell group had the highest median score (3.00 +/- 0.0) at week 12, which was significantly higher than scores for the scaffold and adipose-derived mesenchymal stem cell group and the blank defect group. Conclusion: 17-Estradiol appears to be a novel and promising agent for future cell-based bone tissue-engineering studies

Unusual presentation of a cutaneous malignancy: Giant merkel cell carcinoma with intra-abdominal metastasis

Merkel cell carcinoma (MCC) is a rare and aggressive cutaneous malignancy with uncertain histogenesis. Here, we present an unusual presentation of giant MCC of the skin with concomitant intra-abdominal metastasis to pancreas. A 53-year-old man was admitted to our clinic with a giant ulcerated mass in the gluteal region. Incisional biopsy of the mass revealed primary poorly differentiated neuroendocrine tumor of the cutaneous origin and confirmed the diagnosis of MCC. Clinically, the patient complained of abdominal discomfort and weight loss of 15 kg over the past 4 months. Intra-abdominal computerized tomographic examination demonstrated a heterogenous-appearing giant mass of the right upper quadrant invading the superior mesenteric artery and leading to obstruction of common biliary duct and a second mass (6 cm Χ 6 cm) located at the inferior pole of pancreas extending toward the duodenum. As the gluteal mass was prone to trauma and leading to massive hemorrhage, excision of the gluteal mass with 2 cm of tumor-free margin was performed. V-Y advancement flap based on the perforators of the inferior gluteal and profunda femoris artery was elevated to cover the resulting defect (22 cm Χ 17 cm). Although the patient was referred to medical oncology for further therapeutic management, he could only survive for 11 months from his initial diagnosis. We would like to emphasize that MCC has the potential to spread to unusual organs in short intervals and prompt evaluation and proper management is essential for optimal survival of these patients

Photobiomodulation with polychromatic light increases zone 4 survival of transverse rectus abdominis musculocutaneous flap

Objective The aim of this study was to evaluate the effect of relatively novel approach of application of polychromatic light waves on flap survival of experimental musculocutaneous flap model and to investigate efficacy of this modality as a delay procedure to increase vascularization of zone 4 of transverse rectus abdominis musculocutaneous (TRAM) flap. Methods Twenty-one Wistar rats were randomized and divided into 3 experimental groups (n = 7 each). In group 1 (control group), after being raised, the TRAM flap was sutured back to its bed without any further intervention. In group 2 (delay group), photobiomodulation (PBM) was applied for 7 days as a delay procedure, before elevation of the flap. In group 3 (PBM group), the TRAM flap was elevated, and PBM was administered immediately after the flap was sutured back to its bed for therapeutic purpose. PBM was applied in 48 hours interval from 10 cm. distance to the whole abdominal wall both in groups 2 and 3 for one week. After 7 days of postoperative follow-up, as the demarcation of necrosis of the skin paddle was obvious, skin flap survival was further evaluated by macroscopic, histological and microangiographic analysis. Results The mean percentage of skin flap necrosis was 56.17 +/- 23.68 for group 1, 30.92 +/- 17.46 for group 2 and 22.73 +/- 12.98 for group 3 PBM receiving groups 2 and 3 revealed less necrosis when compared to control group and this difference was statistically significant. Vascularization in zone 4 of PBM applied groups 2 and 3 was higher compared to group 1 (P = 0.001). Acute inflammation in zone 4 of group 1 was significantly higher compared to groups 2 and 3 (P = 0.025). Similarly, evaluation of zone 1 of the flaps reveled more inflammation and less vascularization among the samples of the control group (P = 0.006 and P = 0.007, respectively). Comparison of PBM receiving two groups did not demonstrate further difference in means of vascularization and inflammation density (P = 0.259). Conclusion Application of PBM in polychromatic fashion enhances skin flap survival in experimental TRAM flap model both on preoperative basis as a delay procedure or as a therapeutic approach. Lasers Surg. 51:538-549, 2019. (c) 2019 Wiley Periodicals, Inc